Drawing a Family Map

Drawing a family map: an experiential tool forengaging children in family therapy

Raymonde H. Dumonta

Inclusion of children in the treatment process is a central aspect of thediscipline of family therapy. Young children’s verbal skill and level ofabstraction may not be suited to ‘talking therapy’, but they have anintuitive grasp of family life which is invaluable, and their views and needsshould be considered when effecting change in the family system. Amethod is offered to engage young children, adolescents and adults ofdivergent verbal skills into a shared process. It requires no special set-upor tools, only paper and markers. Distance and proximity are representedin a simple map of the family, adding symbols for affection and conflict. Aspatial representation of the family system is created, and may be referredto in the course of the therapy.

Introduction

The philosophical stance of the discipline of family therapy, and its earlyinfluential figures, emphasize the importance of participation of allfamily members in the process of therapy (Ackerman, 1970; Minuchin,1974; Satir, 1983; Whitaker, 1982). In the years since, several authorshave elaborated on the reasons to view children as essential participantsin the treatment. They influence the function of the parent system,which can only be partially understood if one works without thechildren. Their spontaneous and intuitive grasp of family life providesinvaluable information. Children are deeply affected by their family,and their needs should be considered in effecting change (Gil, 1994;Keith and Whitaker, 1981; Villeneuve and LaRoche, 1993; Zilbach et al.,1972). In addition, the outcome of therapy is worse when youngstersview their family as more dysfunctional than do the parents (Dancyger etal., 2005). Children’s representations of their family have been shown tobe stable over time and to predict their adjustment (Roe et al., 2006).

r The Association for Family Therapy 2008. Published by Blackwell Publishing, 9600 GarsingtonRoad, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA.Journal of Family Therapy (2008) 30: 247–2590163-4445 (print); 1467-6427 (online)

Correspondence to: Raymonde H. Dumont, MD, Family Therapy and Behavioral Medicine,Tamarack Place, PO Box 470, Hancock, ME 04640, USA. E-mail: [email protected].

a Work initiated as Senior Clinic Physician, Joslin Diabetes Center, Assistant ClinicalProfessor of Pediatrics, Harvard Medical School, Trainee, Kantor Family Institute.

r 2008 The Author. Journal compilation r 2008 The Association for Family Therapy and Systemic Practice

Although most family therapists would acknowledge the importanceof including children in their work, a comprehensive review by Lundet al. (2002) notes that family therapists often treat families in theabsence of younger children. A number of authors have addressed thefactors which contribute to this (Johnson and Volker, 1999; Korner andBrown, 1990; Miller and McLeod, 2001; O’Brien and Loudon, 1985).The evidence suggests that the therapist’s own comfort level withchildren and with play has a stronger determining influence onwhether children are included in the therapy process than thetherapist’s theoretical views on the issue. Certainly, in order to workwith young children, one’s approach has to be less cognitive, less verbaland more playful. Otherwise, the bored child may well becomedisruptive of the therapy process (Chasin, 1994; Scharff, 1989;Villeneuve and LaRoche, 1993). O’Brien and Loudon (1985) foundthat therapists often lack confidence about how to adequately engagechildren, and Korner and Brown (1990) pointed out that training oftenlacks in this respect, compounding the attitudes therapists may havebrought to their work from earlier life experiences. Although therehave been recommendations as to how this could be addressed intraining (Sori and Sprenkle, 2004) a literature search found little toindicate the emergence of new methods. The following tool is offered inthe hope that therapists will find it easy to use, whether or not theywere extensively trained to work with children.

Building on various other techniques, the author has developed asimple method for engaging younger children in joint explorationwith older family members, and accessing their intuitive grasp offamily life. The procedure involves drawing a schematic ‘map’ offamily interactions. It relies on standardized elements and instruc-tions, which most children as young as age 3 can grasp, and which canbe equally used by teenagers. The information gathered is madevisually clear to all as it unfolds in a non-threatening and somewhatabstract way. The ‘map’ thus created is not treated as ‘objective truth’,but rather as the child’s experience of the family system. It blendsverbal with non-verbal communication. It can serve as a frameworkfor future wishes and a touchstone to evaluate future growth.

Description of the method

The therapist begins the ‘map session’ by designating whose view ofthe family system will be represented, and who will serve to assist inthe process. When there is more than one child in the sessions they

248 Raymonde H. Dumont


will often cooperate on their map of family politics. Sometimes (e.g.when one child seems to dominate the other’s thinking), each draws aseparate map. The therapist gets down to floor level, makes a largecircle on oversized paper, and indicates that there will be room in thisspace for each family member (and important pets). If the parents areseparated, two large circles may be traced instead, to represent bothhouseholds. Outside the circle are school, work, neighbourhood andso on. The children then select a colour for themselves and for eachparent or other person in the household. Each person is given ‘their’marker, while the therapist keeps those of absent people.

The child is then asked to consider whom to represent first with acolour circle, how large and where. Even very young children graspthat the largest circle is not meant to represent the largest person, butrather to represent someone who ‘takes up the most space’. Theexample is given of how a baby might in fact get the biggest circle.Often, the mother is drawn first and at the centre. Other circles areplaced inside the family space, one at a time. The child ponders theexact location and size of each circle, tracing it on the paper with afinger, and then directs the family member (or the therapist) until thedrawing is ‘right’. Others are reminded that they need not agree; theyare merely assisting the ‘director’ child in drawing her representation.Thus, the child has the experience of empowerment as all help inrealizing her ideas. When several children cooperate in one project,time is allowed for debate, and before anyone draws what thechild(ren) have instructed, the therapist asks: ‘Are you sure?’ Whenall family members are situated, connections are drawn on the map.Yellow double lines (‘warm fuzzies’) are used to connect any twopeople who are particularly close to each other. Brown zigzagginglines (‘lightning’) are traced between any two people who are prone toarguments. The children are reassured that there is no need to makeall connections equal, but the point is not belaboured if a child seemsreluctant to make distinctions. It may be helpful to enquire aboutsequence. The interaction lines may then be labelled 1-2-3 and so on,or the ‘spread’ of the emotion traced with arrows across the map, as isfurther explained below.

The interpretation of the map, and the wish

The interpretation of the map may or may not be concurrent with thedrawing, is given more than one session if needed, and initiates thetherapeutic process as previously unnoticed alternatives become

Engaging children in family therapy 249


apparent. The therapist notes the relative size and closeness of variousfamily members, and gives the child a chance to make corrections.The therapist creates an atmosphere of joint enquiry as curiosity isencouraged in all, and judgement or defensive protests are gentlyredirected. In tracing the sequence of interactions, specific examplesand predictable patterns are cited, such as: ‘Suzie teases Adam, Dadgets upset at the noise, Jimmy feels compelled to silence his youngersiblings, Mom tells him to mind his own business, and then they fight.’The alliances are noted. A more peripheral family member’s positioncan be interpreted in light of roles and developmental tasks (e.g. ateenager might be home less; one parent may work longer hours). Achild’s sensitivity to tension will emerge as she equalizes all theconnections in the family. Another child’s sense of exclusion or aparent’s peripheral role can be seen.

It is helpful to remind the parents again that it is not objectivereality which is being depicted, but a child’s experience of her family.Children are often apprehensive about a parent’s reactions to their‘knowing’. The therapist models appreciation of the children’s per-ceptiveness and thanks them for contributing to make things betterfor all concerned. Parents may need support as they discover howmuch their children see that was assumed to be beyond their years,learn of a child’s discomfort, or get depicted as peripheral or over-powering. It may be best to spend a few minutes without the childrenbefore the end of the session, to give parents a more explicit ‘interim’interpretation of the findings, and re-establish ground rules abouthow to interact with the children until the next session.

Finally, the child(ren) may be asked to modify the map or draw a newone about their wish for the future. There are times when they state ‘itis OK this way’, but rarely are they unable to identify any improvementsto the family system. The wish may be used to construct the goals oftherapy, and be referred back to at a later date to monitor progress.

Case examples

Case 1

(See Figure 1.) Kathy and Dan had been in marital therapy for sometime. They were contemplating divorce, and were both very con-cerned about the impact this would have on Sarah, 3 years old, andWilly, 6 years old. They believed that the children knew nothing oftheir parents’ difficulties, and would be better served with the status



quo. The children were brought in and drew a family map together.They agreed that Dad, the at-home parent, should be in the centre.Mum had been responding to the problems by working more, andwas depicted near the edge of the family circle. The children,unasked, drew stick figures of themselves inside both parents’ circles.Sarah was placed very close to Mum, nearly touching her circle, andWilly closer to Dad, representing himself as a boat. Warm-fuzzy lineswere carefully and equally distributed. The children needed muchreassurance before drawing conflict lines between Mum and Dad.Both then sent fearful glances to their parents and Sarah suddenlycovered her own circle with thick black lines, and climbed into Mum’slap for the rest of the session, hiding with her hand at her mouth.Willy asked for more paper to draw more boats, insisted on telling usabout them in great detail, and interrupted all further talk until wemoved to more neutral ground to close the session.

Kathy and Dan, in follow-up, came to terms with the fact that themarital conflict affected their children. They separated, and made

Figure 1. Kathy and Dan’s family map



housing and parenting decisions based primarily on the children’sneeds. The general tension decreased, though Willy continued todemonstrate somewhat obsessive preoccupations, and was entered ina successful course of individual therapy for anxiety.

Case 2

(See Figure 2.). After a few sessions of couples therapy, Dick andJoanna brought in their three children to explore the effects of thefather’s debilitating chronic illness. Dad was in pain much of the time,depressed by his progressive disability, and irritable. Farm and house-hold chores fell increasingly to Mum, 14-year-old Emma and 10-year-old Amy, less so to 8-year-old Johnny. In a session with all five familymembers, Amy did not engage until she was invited to draw the familymap. She portrayed Dad as a large circle covering half of the availablefamily ‘space’, placed herself and Mum both within Dad’s circle, thenEmma and Johnny separately in the family space. She drew strongpositive connections between Dad and Johnny, and much conflict

Figure 2. Dick and Joanna’s family map



elsewhere, especially around herself. She was angry with her oldersister’s ‘bossiness’ and her younger brother’s chore-free ‘privilege’.She told us how deeply she experienced Dad’s moods and hissuffering, and that ‘just like him’, she got crabby when things weren’tgoing well. The family responded with a discussion of how thingsmight be made better for all.

Seven years after these family sessions, Amy (now a college student)sought therapy for depression. When she was shown the family mapshe had created years before, she did not remember drawing it,but recognized how she had always identified with her father andhis ‘moods’. This helped her to understand her own depression in thefamily context.

Case 3

(See Figure 3.) Sherry and Donna entered family therapy with their6-year-old son Aaron and 12-year-old daughter Callie because ‘wehave trouble getting along, especially Callie’. At first Callie retreatedangrily behind the couch. She agreed to participate only whendrawing implements were produced. She issued orders to her brotherwho seemed very anxious to please her. None the less, there wassufficient genuine agreement in their impressions of the family not toresort to separate maps. To the initial consternation of ‘Mum’ and‘Mummy’, Sherry’s shape took up most of the family space, dwarfingDonna and the children equally. Callie and Sherry were depicted atopposite ends of the family map, with Aaron and Donna betweenthem. The sequence of conflict was as follows: (1) Sherry comes hometired from work and finds that Donna has not done her share ofhousehold chores, nor asked the children to pick up after themselves.(2) She demands a family effort, which Callie angrily resists. (3) Donnacriticizes Sherry for being so intense. (4) Callie inserts herself in thefight, and she and Mum blow up at each other. (5) Aaron retreats infear. (6) The parents do not speak for days.

It emerged that the children were often confused as to what wasactually expected from them, and by whom. Clarification of familyrules foundered as Sherry stated her expectations, and Donnaresponded with ‘I suppose’ and a noncommittal shrug. Callie angrilypointed out, ‘it is always like that’. The therapist suggested that theparents address their differences in a session without Callie andAaron. The children happily signed over the ‘problem with theirparents’ to the therapist, and the couple addressed the pattern of



Donna’s passivity and Sherry’s frustrated escalation. Tracing thesequence of conflict on the family map had shifted the focus fromthe identified patient to the parent system.

Discussion

Small children have limited facility with abstract language. In familytherapy this impacts on their ability to describe their experience of

Figure 3. Sherry and Donna’s family map



family life, view of relationships, or contributions to possible solutions.Several authors have claimed that therapists who are familiar withtools appropriate to younger children are more likely to modify theformat of therapy than to exclude children from the therapy room. Intreating families with children, early structural family therapists andsome strategic therapists relied upon enactment of the presentingproblem within the session. Experiential techniques included a varietyof sculpting or enacting methods. Play naturally engages children,and drawings are often used by play therapists and art therapists alike.Nevertheless, the literature describes few methods which will workwell with young children in conjunction with more verbal adolescents andadults in family sessions. This paper offers a simple technique forengaging younger children, and accessing their intuitive perceptionsof the family. The method, developed from aspects of various existingtechniques, requires no complicated set-up and no specialized tools ortoys. Importantly, the technique involves the entire family in a sharedexploration, in spite of widely differing verbal skills.

The family map technique was influenced by family sculpting,developed by Duhl et al. (1973) as a means of eliciting active spatiallearning about family relationships, in order to free up the family’scapacity for transformation. Sculpting is akin to psychodrama (Blatner,1994) although it captures a tableau vivant (Simon, 1972), rather than anentire action. Like sculpting, the family map accesses non-verbal learn-ing, and concerns itself with personal space and distance. It visualizesaffection and anger, and traces the sequence of events in the familysphere. It makes clear at the onset whose views of the family are beingrepresented as distinct from an ‘objective’ reality, and others are givenroles as ‘actors’ and/or ‘audience’. Absent ‘players’ are represented.Despite these similarities, the method of the map is different fromsculpting. The experience is created on paper rather than by stagingfamily members’ positions, expressions and body language. Whereasmany families are reluctant to get up and ‘act’, most are immediatelycomfortable with paper and coloured markers, and engage in genuineexpression and transformation. The children produce a lasting recordto refer to later on, which can benefit the review of progress intreatment, and even many years later in follow-up.

Other sculpture techniques, such as the Kvebaek Family SculptureTechnique and the FAST or Family Systems Test (Gehring and Wyler,1986; Gehring and Marti, 1993b), depict the ‘architecture’ of familystructures with figures to be arranged on a board, and apply scoringprocedures to determine cohesion and hierarchy within the family.



These tools have proven useful in research as well as clinically(Gehring and Marti, 1993a). The family map however is not intendedas a diagnostic tool. Rather, it assists children in communicating theirexperience of the family directly to their parents.

As in structural family therapy (Minuchin, 1974), a simple map of thefamily system is created. Symbols for enmeshed, distant or appropriateboundaries drawn by the therapist are replaced by the child’s intuitiverepresentation of relative distance, affection and conflict. Whereasstructural and strategic therapists have used enactment of the familyproblem in session, the map allows for enactment on paper, when ittraces the sequence of conflict through the family system.

The symbolic drawing of the family (Geddes and Medway, 1977) andthe family circles (Asen et al., 2004) invite all family members to placecircles within or outside a large family space to represent immediatefamily as well as extended family, important others and any relevantinstitutions. Each person rates her communication with the people andinstitutions on the drawing as ‘good’, ‘so-so’ or ‘bad’, and a livelydiscussion of the different views of proximity and relative size of thecircles is encouraged. As Asen suggests, even children as young as 3 canplace circles, but the family map invites only the children’s perceptions, toensure that they are not overshadowed by more verbal family mem-bers. In addition, it usually focuses only on immediate family, and itdepicts affection and conflict explicitly, albeit in a playful way. Thesedifferences make the map accessible to even very young children.

Keith and Whitaker (1981) argue that play is a powerful, perhapsessential tool in any successful family therapy, as do proponents offamily play therapy (Anderson, 1993; Busby and Lufkin, 1992;Kaslow and Racusin, 1990; Scharff, 1989), but play therapy hasmore often been used in individual therapy, or in child-centred filialplay. Miller (1994) pointed out that the disciplines of play therapy andof family therapy have diverged more than cross-fertilized. Larner(1996) uses a combination of play and narrative techniques inindividual child sessions, and then incorporates what is learned intoseparate family sessions. The family map shares the ‘as if ’ quality ofplay therapy. The activity of drawing, like play, makes the commu-nication feel less direct and less threatening. This helps children toshare material which might otherwise be more defended and lessaccessible. The technique also borrows from the narrative tradition insupporting children, in a safe setting, to comment on others’ position inthe family and to entertain alternative outcomes in a mood ofplayfulness. However, it does so with spacial representation on paper,



rather than with stories and verbal approaches like circular question-ing (Benson, 1991; Larner, 1996).

The method differs from art therapy in that it does not rely oncreative self-expression (Retzlaff, 2005). In the familiar ‘draw a familypicture’, ‘kinetic family drawing’ and the ‘drawing up of boundaries’(Burns and Kaufman, 1971; Wilkinson, 1985) objects and figures arerepresented and interpreted. While ‘naive observers’ can successfullydistinguish important elements in children’s drawings (Stein, 2001),interpretation of such complex material requires caution. Restrictingthe assessment to specific elements of children’s drawings has provenuseful, both clinically and in research: Roe et al. (2006) demonstratedthat a young child’s exclusion of family members from a familydrawing, as well as placement of the parents together or apart, arestable features over time which predict adjustment. Similarly, thefamily map restricts its elements to symbolic, more abstract represen-tation, and helps the children verbalize these.

The mixing of verbal and non-verbal modalities facilitates the processof engaging children and adolescents of different developmental levelssimultaneously and the exercise validates the personal reality of eventhe youngest child. The activity is directed and structured by thetherapist. Parents are helped to receive communications from the childabout the family, with the goal of ‘making things as good as they can befor everyone’. Cooklin (2001) pointed out that the exclusive use of playand non-verbal communication with young children risks underutiliz-ing their capacity to think; the family map aims to stimulate their criticalthinking and create a common language with older family members.

Before choosing to set up this activity, the therapist must decidewhether it is safe to do so. If there is abuse in the family system,encouraging free expression can endanger the children or otherfamily members. Most parents will readily agree that ‘there should beno punishment at home for anything the children may express here’,and Chasin (1994) suggests that ‘nobody needs to answer any ques-tions if they don’t want to’. Yet however careful one may be, there aretimes when a well-kept family secret may be revealed or uncovered bya child. It is wise to remember that children often self-protect bybecoming withdrawn or disruptive in such circumstances and it maybe a mistake to dismantle a necessary self-protection. Non-verbal cuesto ‘danger areas’ are vital information for the therapist, but it may bewiser to explore their meaning at a later time.

In summary, ‘drawing a family map’ is offered as a technique forfamily therapists to engage young children, adolescents and adults at



widely different levels of development and verbal skill into a sharedprocess. This offers important information, which is intuitively acces-sible to younger children and to the entire family through the use of asimple colour map, and provides a lasting visual record to refer to asthe therapy proceeds.

References

Ackerman, N. (1970) Child participation in family therapy. Family Process, 9:403–410.

Anderson, R. A. (1993) As the child plays, so grows the family tree: family playtherapy. In (eds), Play Therapy in Action: A Casebook for Practitioners (pp. 457–483). Northvale, NJ: Aronson.

Asen, E., Tomson, D., Young, V. and Tomson, P. (2004) Ten Minutes for the Family:Systemic Interventions in Primary Care. London: Routledge.

Benson, M. J. (1991) Accessing children’s perceptions of their family: circularquestioning revisited. Journal of Marital and Family Therapy, 17: 363–372.

Blatner, A. (1994) Psychodramatic methods in family therapy. In (eds), Family PlayTherapy (pp. 235–246). Northvale, NJ: Aronson.

Burns, R. C. and Kaufman, S. H. (1971) Kinetic Family Drawings. London:Constable.

Busby, D. M. and Lufkin, A. C. (1992) Tigers are something else: a case for familyplay. Contemporary Family Therapy, 14: 437–453.

Chasin, R. (1994) Interviewing families with children: guidelines and suggestions.Psychotherapy and the Family, 5: 17–30.

Cooklin, A. (2001) Eliciting children’s thinking in families in family therapy.Family Process, 40: 293–312.

Dancyger, I., Fornari, V., Scionti, L., Wisotsky, W. and Sunday, S. (2005) Dodaughters with eating disorders agree with their parents’ perceptions of familyfunctioning? Comprehensive Psychiatry, 46: 135–139.

Duhl, F. J., Kantor, D. and Duhl, B. S. (1973) Learning, space and action in familytherapy: a primer of sculpture. Seminars in Psychiatry, 5: 167–183.

Geddes, M. and Medway, J. (1977) The symbolic drawing of the family space.Family Process, 16: 219–228.

Gehring, T. M. and Wyler, I. L. (1986) Family System Test (FAST): a three-dimensional approach to investigate family relationships. Child Psychiatry andHuman Development, 16: 235–248.

Gehring, T. M. and Marti, D. (1993a) The architecture of family structures:toward a spacial concept for measuring cohesion and hierarchy. Family Process,32: 135–139.

Gehring, T. M. and Marti, D. (1993b) The family system test: differences inperception of family structures between nonclinical and clinical children.Journal of Child Psychology and Psychiatry, 34: 363–377.

Gil, E. (1994) Play in Family Therapy. New York: Guilford Press.Johnson, L. and Volker, T. (1999) Influences on the inclusion of children in family

therapy. Brief report. Journal of Marital and Family Therapy, 25: 117–123.



Kaslow, N. J. and Racusin, G. R. (1990) Family therapy or child therapy: an openor shut case. Journal of Family Psychology, 3: 273–289.

Keith, D. V. and Whitaker, C. A. (1981) Play therapy: a paradigm for work withfamilies. Journal of Marital and Family Therapy, 7: 243–254.

Korner, S. and Brown, G. (1990) Exclusion of children from family psychother-apy: family therapists’ beliefs and practices. Journal of Family Psychology, 3:420–430.

Larner, G. (1996) Narrative child family therapy. Family Process, 35: 423–440.Lund, L. K., Zimmerman, T. S. and Haddock, S. A. (2002) The theory, structure

and techniques for the inclusion of children in family therapy: a literaturereview. Journal of Marital and Family Therapy, 28: 445–454.

Miller, L. M. and McLeod, E. (2001) Children as participants in family therapy:practice, research and theoretical concerns. The Family Journal: Counseling andTherapy for Couples and Families, 9: 375–383.

Miller, W. M. (1994) Family play therapy: history, theory and convergence. In(eds), Family Play Therapy (pp. 3–19). Northvale, NJ: Aronson.

Minuchin, S. (1974) Families and Family Therapy. London: Tavistock.O’Brien, A. and Loudon, P. (1985) Redressing the balance – involving children in

family therapy. Journal of Family Therapy, 7: 81–98.Retzlaff, R. (2005) Drawings and art work in systemic family therapy. Praxis der

Kinderpsychologie und Kinderpsychiatrie, 54: 19–36.Roe, A. and Bridges, L. et al. (2006) Young children’s representations of their

families: a longitudinal follow-up study of family drawings by children living indifferent family settings. International Journal of Behavioral Development, 30:529–536.

Satir, V. (1983) Conjoint Family Therapy. Palo Alto: Science and Behavior Books.Scharff, J. S. (1989) Play with young children in family therapy: an extension of

the therapist’s holding capacity. Journal of Psychotherapy and The Family, 5:159–172.

Simon, R. M. (1972) Sculpting the family. Family Process, 11: 49–57.Sori, C. F. and Sprenkle, D. H. (2004) Training family therapists to work with

children and families: a modified Delphi Study. Journal of Marital and FamilyTherapy, 30: 479–495.

Stein, M. T. (2001) The use of family drawings in pediatric practice. Journal ofDevelopmental and Behavioral Pediatrics, 22: S49–54.

Villeneuve, C. and LaRoche, C. (1993) The child’s participation in family therapy:a review and a model. Contemporary Family Therapy, 15: 105–119.

Whitaker, C. A. (1982) The ongoing training of the psychotherapist. In (eds), FromPsyche to System: The Evolving Therapy of Carl Whitaker. New York: GuilfordPress.

Wilkinson, S. (1985) Drawing up boundaries: a technique. Journal of FamilyTherapy, 7: 99–111.

Zilbach, J. J., Bergel, E. and Gass, C. (1972) The role of the young child in familytherapy. In (eds), Progress in Group and Family Therapy. New York: Brunner/Mazel.



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Drawing a Family Map